Purpose of ReviewThe dictum of surgical metabolism describing the ebb and flow of nutrients after injury can be seen as an alteration of the hormonal milieu. Shock, therefore, is a state by which nutrients are delivered only by diffusion, while shock resolution is marked by a transition to nutrient diversion into essential and salvage pathways. The gut requires significant cardiac output at rest, and this demand increases during enteral feeding. The mismatch between supply and demand can be exacerbated during the shock state, or, paradoxically, improved.Recent FindingsEnteral nutrition (EN) should be initiated within 24–48 h of the resolution of the shock state, and monitoring for feeding intolerance should be continued throughout recovery. Enteral formulas with additive amino acids or antioxidants have mixed reviews; however, “immunonutrition” is well supported.SummaryCareful attention to nutritional assessment and provision during the earliest phases of critical care, specifically shock, provides the best outcomes.